Atlas of Renal Pathology No. 1

ATLAS OF RENAL PATHOLOGY

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Cortical Necrosis

Pathology Editor: Agnes Fogo, MD
Medical Photographer: Brent Weedman

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Fig 1. Cortical necrosis is distinguished from acute tubular necrosis in that glomeruli as well as tubules show frank necrosis. It most often has a vascular occlusive etiology. Coagulative necrosis is widespread in this transplant biopsy and is manifest by small, pyknotic nuclei and ghost-like outlines of cells, characteristic of coagulative necrosis (periodic acid Schiff, x400).

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Fig 2. Cortical necrosis with tubular necrosis and glomerular necrosis. The glomerular basement membrane is still visualized, but there are no viable nuclei in the glomerulus, and surrounding tubules show frank necrosis, as do the adjacent arterioles (Jones' silver stain, x400).

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Fig 3. Cortical necrosis with widespread frank tubular necrosis with no nuclei discernible in tubules and ghost-like outlines of cells, characteristic of coagulative necrosis (periodic acid Schiff, x200).

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Fig 4. Cortical necrosis with widespread frank tubular necrosis with no nuclei discernible in most tubules and ghost-like outlines of cells, characteristic of coagulative necrosis. There are also pyknotic nuclei and karryorhexis, characteristic of coagulative necrosis (periodic acid Schiff, x400).

From the Department of Pathology, Vanderbilt University Medical Center, Nashville, TN.
Address author queries to Agnes Fogo, MD, Department of Pathology, Vanderbilt University Medical Center, MCN C-3310, Nashville, TN 37232. E-mail:Agnes.Fogo@vanderbilt.edu
Copyright © 2003 by the National Kidney Foundation, Inc.